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Gastroparesis

Gastroparesis diabeticorum; Delayed gastric emptying; Diabetes - gastroparesis; Diabetic neuropathy - gastroparesis

Gastroparesis is a condition that reduces the ability of the stomach to empty its contents. It does not involve a blockage (obstruction).

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Causes

The exact cause of gastroparesis is unknown. It may be caused by a disruption of nerve signals to the stomach. The condition is a common complication of diabetes. It can also follow some surgeries.

Risk factors for gastroparesis include:

• Diabetes
• Gastrectomy (surgery to remove part of the stomach)
• Systemic sclerosis
• Use of medicine that blocks certain nerve signals (anticholinergic medicine)

Symptoms

Symptoms may include:

• Abdominal distention
• Hypoglycemia (in people with diabetes)
• Nausea
• Premature abdominal fullness after meals
• Weight loss without trying
• Vomiting
• Abdominal pain

Exams and Tests

Tests you may need include:

• Esophagogastroduodenoscopy (EGD)
• Gastric emptying study (using isotope labeling of ingested food)
• Upper GI series

Treatment

People with diabetes should always control their blood sugar level. Better control of blood sugar level may improve symptoms of gastroparesis. Eating small and more frequent meals and soft foods may also help relieve some symptoms.

Medicines that may help include:

• Cholinergic drugs, which act on acetylcholine nerve receptors
• Erythromycin
• Metoclopramide, a medicine that helps empty the stomach
• Serotonin antagonist drugs, which act on serotonin receptors

Other treatments may include:

• Botulinum toxin (Botox) injected into the outlet of the stomach (pylorus)
• Surgical procedure that creates an opening between the stomach and small intestine to allow food to move through the digestive tract more easily (gastroenterostomy)

Outlook (Prognosis)

Many treatments seem to provide only temporary benefit.

Possible Complications

Ongoing nausea and vomiting may cause:

• Dehydration
• Electrolyte imbalances
• Malnutrition

People with diabetes may have serious complications from poor blood sugar control.

When to Contact a Medical Professional

Changes in your diet may help control symptoms. Contact your health care provider if symptoms continue or if you have new symptoms.

Related Information

References

Bircher G, Woodrow G. Gastroenterology and nutrition in chronic kidney disease. In: Feehally J, Floege J, Tonelli M, Johnson RJ, eds. Comprehensive Clinical Nephrology. 6th ed. Philadelphia, PA: Elsevier; 2019:chap 86.

Koch KL. Gastric neuromuscular function and neuromuscular disorders. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 50.

Review Date: 10/27/2020  

Reviewed By: Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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